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Minnesota rates for HCPCS 0095U

Eosinophilic esophagitis, 2 protein biomarkers (Eotaxin-3 [CCL26 {C-C motif chemokine ligand 26}] and Major Basic Protein [PRG2 {proteoglycan 2, pro eosinophil major basic protein}]), enzyme-linked immunosorbent assays (ELISA), specimen obtained by esophageal string test device, algorithm reported as probability of active or inactive eosinophilic esophagitis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $724.44 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $616.60 / $933.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $776.25 / $776.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $776.25 / $776.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $2,951.21 / $7,079.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,122.02 / $1,513.56
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $2,630.27 / $5,623.41
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $1,479.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $1,202.26 / $3,630.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $467.74 / $1,621.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $776.25 / $933.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $776.25 / $1,698.24